1. General Instructions1. Introduction
a) This form is to be completed for each licensed insurance entity. Each insurer within a group of companies is required to complete the form for the policies it has issued. This includes any portion of its policies included in a risk
sharing pool, such as Facility Association.
b) The information that is collected will be subject to and administered in accordance with the provisions of the Memorandum of Understanding and Protocol on Cooperation and the Exchange of Information (the “MOU”) and the
applicable law. This includes the privacy and confidentiality provisions included with the MOU and the applicable law.
c) MOU signatories have entered into agreements with the Autorité des marchés financiers (AMF) to collect on behalf of the provincial and territorial regulatory authorities where applicable.
d) Aspects of the information that is collected are considered commercially sensitive and will be treated as such by the CCIR and its members.
e) The information that is sought relates to the insurer’s Canadian operations and/or Canadian consumers. Information regarding activities or developments abroad is limited to that which may impact Canadian operations and
consumers.
f) The data provided must cover the most recent fiscal year end.
g) This form relates only to personal insurance. Reinsurance is excluded and insurers dealing exclusively in reinsurance are not required to complete the Annual Statement on Market Conduct.. Commercial insurance is
excluded for all sections except for the Complaint Reporting Sections. Commercial insurance complaints are expected to be reported in those sections dealing with consumer complaints as they are currently recorded in the
National Complaint Reporting System. Licensed personal lines insurers that do not operate in that space (i.e., do not sell or provide personal lines insurance policies) are required to complete only those sections addressing
governance and consumer complaints.
h) The information requested is required to establish trends and evaluate the means implemented by the industry regarding fair treatment of consumers.
i) The obligations contained or imposed by the Annual Statement on Market Conduct do not in any way supersede any relevant law or regulation within Canada or any of the CCIR member jurisdictions.
2. Filling requirements
a) All amounts reported should be in thousands of dollars ($000s).
b) Some fields will only accept a numeric response.
c) You must complete this form respecting as much as possible, the choices available in the dropdown menus.
d) You must provide a response to all questions. If the response options do not apply or relate to your company, please select "Other" and provide details in the appropriate space.
e) At the end of each section, a general comments section has been provided for any additional comments you may wish to provide.
3. Definitions
a) Breaches (of privacy) reported in this form are those that have a significant impact on the customer and require disclosure under applicable privacy legislation.
b) Broker includes general agent and managing general agent («MGA»).
c) A complaint is the expression of at least one of the following elements that persists after being considered and examined at the operational level capable of making a decision on the matter:
• a reproach against an organization;
• the identification of a real or potential harm that a consumer has experienced or may experience;
• a request for a remedial action.
Complaints are generally expressed in writing through correspondence, e-mail, fax or other form that allows a complaint to be kept on file. Where a consumer makes a complaint by phone or in person and the complaint is
handled and examined by the person responsible for the examination of complaints and designated as such in the organization’s policy, the complaint must be documented so that it can be kept on file.
The initial expression of dissatisfaction by a consumer, whether in writing or otherwise, will not be considered a complaint where the issue is settled in the ordinary course of business. However, in the event the consumer
remains dissatisfied and such dissatisfaction is referred to the person who is responsible for the examination of complaints and designated as such in the organization’s policy, then it will be considered as a complaint.
However, organizations must refrain from any undue delay in referring a matter to a higher level solely for the purpose of avoiding reporting requirements.
Where a consumer remains dissatisfied after a reasonable attempt has been made to settle the issue, organizations without a multilevel complaint examination structure are then considered to have received a complaint.
1. General Instructions3. Definitions (suite)
d) Consumer means all current and prospective customers of insurance products.
e) Employee means any salaried employee of an insurer working more than 25 hours per week, but does not include an employee paid primarily by commission.
f) Fair treatment of consumers ("FTC") is a principle that focuses on consumer outcomes, in particular, having due regard for the interests of the consumer and treating the consumer fairly. It refers to the consumer-related
conduct of insurers and how insurers treat consumers at each stage of the life cycle of a product. The lifecycle of the product begins with its design to after-sales services and from the moment obligations under the contract
arise until the point at which all obligations under the contract have been fulfilled.
The outcomes associated with FTC as described by the International Association of Insurance Supervisors (IAIS) include the following:
• Developing and marketing products in a way that pays due regard to the interests of customers;
• Providing customers with clear information before, during and after the point of sale;
• Reducing the risk of sales which are not appropriate to customers’ needs;
• Ensuring that any advice given is of a high quality;
• Dealing with customer complaints and disputes in a fair manner;
• Protecting the privacy of information obtained from customers; and
• Managing the reasonable expectations of customers.
Areas within an insurer and its operations that can influence and help ensure the FTC include:
• Board and senior management responsibility;
• Strategy and decision making;
• Internal processes and mechanisms (controls);
• Performance management;
• Remuneration; and
• Policies and procedures.
The CCIR notes that while these outcomes are intended to be a key component of a globally accepted regulatory framework, the IAIS notes that context and conditions within a given jurisdiction, including legal, regulatory and
financial considerations, will ultimately affect the implementation and application of FTC and its associated outcomes.
g)Lapse refers to the termination of a policy for nonpayment of the premium. This occurs when the policy owner does not pay the premiums on time or the value of the policy (cash value) is insufficient for the payment
requirements.
h) Lawsuit means a court case involving a dispute between the insurer and the insured, based on an insurance product.
i) Market conduct encompasses any product or service relationship between the insurance industry (insurers or intermediaries) and the public, specifically the risks to customers that arise if an insurer or intermediary fails to
treat customers fairly and in accordance with Applicable Law, and includes the terms “conduct of business” and “commercial practices” as used in some jurisdictions.
j) Material change refers to any change that may materially impact or affect the outcomes associated with FTC as described by the International Association of Insurance Supervisors and listed above.
k) Personal Property includes Home and Product Warranty, consistent with the P&C return reporting.
l) Product means all insurance protections marketed under the same name and sold as a whole, although some options are possible. For purposes of this disclosure, an endorsement is not considered an insurance product if it
cannot be sold alone.
m) Regulatory action means any action that results in an order, penalty, fine, or other sanction.
n) Sales management means either an employee of an insurer, a managing general agent, or a third party administrator, responsible for oversight of the sales force.
o) Sales force means those who offer the product to the consumer (for example agents, exempt sellers, restricted licensees and those who offer the product through Quebec's "without a representative" regime).
p) Senior officer in charge of fair treatment of consumers means the person in charge of ensuring the development, implementation and enforcement of fair treatment of consumers-related operational policies and practices.
1. General Instructions4. Detailed instructions
General Information and Governance (2)
a) “Reviews and audits” refers to those conducted by the insurer and include, but are not limited to examinations, compliance reviews, internal audits and other assessments of market conduct.
b) “Organizational or operational changes” includes mergers and acquisitions or other material changes within the insurer that may impact or affect the outcomes associated with FTC as described by the International
Association of Insurance Supervisors and listed above.
c) “Reviews and audits of licensees and third-party distributors” refers to the reviews and audits conducted by the insurer for the reporting period.
Policies (3)
b) “Products covered" include personal property (including home and product warranty for the jurisdictions where appropriate), private passenger automobile, legal expense, mortgage, marine, accident and sickness, personal
credit protection and liability insurance.
Products (4)
a) “Product family” refers to a series of related insurance products that may include variations, but have no material differences. List/include all the products you have sold during the last fiscal year. This includes include personal
property (including home and product warranty for the jurisdictions where appropriate), optional private passenger automobile coverages where appropriate, legal expense, mortgage, marine, accident and sickness, personal
credit protection and liability insurance. It also includes endorsements and new coverages offered to consumers.
b) In the product category column, please indicate the main guarantee only.
c) Changes to be reported are limited to material changes initiated by the insurer or are the result of a decision made by the insurer. Excludes regulatory required changes.
d) “Products covered" includes, but not limited to, personal property (including home and product warranty for the jurisdictions where appropriate), private passenger automobile, legal expense, mortgage, marine, accident and
sickness, personal credit protection and liability insurance.
e) For the column “If yes, list the initial date of change”, please identify the jurisdiction in which the change to the product was first introduced/implemented and the date on which it occurred
Distributors (6)
a) Information on your top 25 firms (determined by amount of direct written premium) is to be reported in this section.
b) Percentage of total business is based upon sales in the reporting period.
c) “Loan” does not include advancement of commissions.
Sales and incentives management (7)
a) List the types of variable remuneration (e.g. cash prizes, training that includes travel, bonuses).
b) List only the incentives that are provided by the insurer. Do not report on incentives provided through other sources, such as those provided by MGAs.
c) For “Lapses by distribution channel”, identify the number of policies.
d) For tables marked 2 and 3, insurers are expected to only include information regarding their direct compensation practices. Compensation practices of any entity to which distribution and sales have been outsourced to are not
expected to be reported.
Claims (8)
a) The information requested in this section is limited to claims that have been initiated for policies that are or were in force at the time the claim was incurred.
b) “Average days to final payment” does not include periodic payment or payments made in installments.
c) For “Number of claims closed within (period) days from date of claim reported”, the initial payment of a periodic payment / first installment of a payment is to be reported.
d) “Personal Property” includes home and product warranty for the jurisdictions where appropriate.
e) The information sought in the tables marked 2 and 3 is limited to complete denials of claims.
f) Only lawsuits related to policies are to be reported in this section.
Protection of Personal Information (10)
a) “Number of breaches” refers to incidents and occurrences based on applicable privacy legislation and provincial insurance legislation. It does not include the number of individuals impacted by the breach.
Attestation (11)
a) The Attestation is to be signed by a senior officer in charge of ensuring the development, implementation and enforcement of policies and practices related to the fair treatment of customers. (This individual is often the CCO
or CEO for smaller firms. It is not the Ombudsperson).
a) Name of the senior officer:
b) Title:
c) Address:
d) Telephone number:
e) Email:
a) Name of the senior officer:
b) Title:
c) Address:
d) Telephone number:
e) Email:
a) Name of the senior officer:
b) Title:
c) Address:
d) Telephone number:
e) Email:
December 31
Yes
Yes
Yes
Yes
Yes
d) Do you intend to develop such a document in the next year?
If no, please answer the questions below:
If yes, please answer the questions below:
a) When was the last time you reviewed/evaluated the code or policy (DD/MM)?
b) When was the last time you modified the code or policy (DD/MM)?
c) Have you communicated this policy to all of your staff?
5. Do you have a code or policy that specifically addresses the fair treatment of consumers/treating
consumers fairly?
6. Is the fair treatment of consumers a priority at each stage of the product life cycle and in every area
of your operations?
2. Governance1. Identify the senior officer(s) in charge of ensuring the development, implementation and enforcement of policies and
practices related to the fair treatment of customers at December 31 (This individual is often the CCO or CEO for smaller
firms. It is not the Ombudsperson):
If no, please explain why the fair treatment of consumers is not a priority of each stage of the product life cycle and in
every area of your operations in the space below:
If yes, please indicate which of the following practices you engage in to ensure the fair treatment of consumers:
1.1 Provide an overview of the processes and responsibilities regarding the development, implementation and
enforcement of policies and practices related to the fair treatment of customers within your organization:
d) Develop measures and reports to inform management of the organization’s performance in the fair treatment
of consumers
2. Please indicate the date for your organization’s fiscal year end:
a) Develop strategies, objectives and initiatives to promote the fair treatment of consumers
b) Embed the fair treatment of consumers in the organization’s policies and code of ethics
If other, please specify the date of your organization's fiscal year end (DD/MM)
c) Develop mechanisms and procedures to identify and address any conflicts that could impact the fair
treatment of consumers
4. Please indicate the total number of employees in your organisation:
4.1 Please indicate the total number of employees whose responsibilities are primarily for facilitating
and monitoring risk management practices over market conduct risk:
3. Are you active in the sale and provision of personal lines insurance?
2. Governance
Yes
If yes, please provide details (which regulator, product concerned, outcome, etc.):
Exclusively through
independant agents
9.1
Yes
h) Potential conflicts of interest
g) Up-to-date information provided in a timely manner
c) Suitability risks associated with the product
a) Please indicate the number of third-parties you engage for the distribution of your products.
b) Please indicate the number of third-party entities within your distribution channel that were the subject of a
review or audit that included a focus on market conduct practices:
d) Please identify the scope of the audit(s)/review(s) conducted over the licensees (agents):
d) Please identify the three most pervasive/frequent market conduct activities and/or conditions (“triggers”) that
led to targeted, risk-based audits or reviews of licensees
c) Please identify the scope of the audit(s)/review(s) conducted over the third-party entities:
9.2
a) Please indicate the total number of licensees ("agents") included within your distribution network.
b) Specifically, please indicate the total number of licensee files (“agent files”) that were reviewed or audited.
c) Please indicate the total number of licenssee ("agent") within your distribution network channel that were the
subject of a review or audit that included a focus on market conduct practices
a) Substitutions or replacement of a product (if applicable)
b) Contract amendments
c) Customer rights and obligations in connection to any material changes in the product that was sold or offered
(if applicable)
d) Changes in the environment that may impact the product (e.g., legislative changes)
11. Please identify from the list below the after sale information provided to the customer:
e) Organizational or operational changes that may impact the customer, product or related services
f) Formatting that is easy to read and understand
a) Insurer name and contact information
b) Product and its main features
10. Do you have processes/mechanisms in place to ensure that the information, as noted below, is
provided at the point of sale (provided before or at the time of purchase)?
d) Right of termination or rescission (if applicable)
e) Clear, plain language communication that is not misleading
d) Please identify the three most pervasive/frequent market conduct activities and/or conditions (“triggers”) that
led to targeted, risk-based audits or reviews of third-party entities
If yes, please indicate which of the following information is disclosed to consumers before or at the time of purchase
(check all that apply):
9. Please select the option that most closely reflects the method of distribution adopted by your
organization:
If you distribute your products exclusively through third-party arrangements, answer questions in section 9.1 only
If you distribute your products exclusively through non third-party arrangements (direct sales), answer questions in section 9.2 only
If you distribute your products through both third-party and non third-party arrangements, answer questions in sections 9.1 and 9.2
7. Please provide an overview of the type and length of training employees receive on hiring and on an ongoing basis with
respect to the fair treatment of consumers:
8. During the past year, have you been the subject of any regulatory action of significance by a
regulator outside of Canada that relates to market conduct that could have a material impact on market
conduct practices in Canada?
2. GovernanceYes
a) Advertising satisfies all applicable legal and regulatory requirements
b) Ensure the name of the insurer is clearly indicated
c) Advertising is appropriate for the target consumer group
d) Written advertisements are presented in a format that is easy to read and understand
e) Advertising is truthful and authentic with respect to the use of statistics and testimonials
f) Unclear, misleading or inaccurate advertisements are promptly modified or withdrawn
Yes
Annually
More frequently than
annually
Annually
Less frequently than
annually
b) Following a claim
d) Other:
c) Following a complaint
12. Do you engage in advertising campaigns directed toward consumers?
If yes, please indicate how often:
a) Following a sale
14. General comments:
If yes, please indicate if you have processes/mechanisms in place to ensure/address the following in your advertising
campaigns:
g) Advertising is reviewed independently of the person who designed or prepared the advertisement prior to its
dissemination
13. Do you conduct customer satisfaction surveys?
Individual
Fully refunded Prorated and
short-rated
Personal Property
Private passenger Automobile
Legal Expense
Mortgage
Marine
Accident and sickness
Credit Protection
Liability
General comments:
3. Policies
Number of insurer-initiated
cancellations with refund of
premiumNumber of applications
from consumer declined
by insurer
Number of customer
initiated cancellations
Number of insurer-
initiated cancellations
Number of customer
initiated non-renewal
Number of insurer
initiated non-renewals
Number of new
policies issued
or renewed
Number of insurer-
initiated cancellations
without any refund of
premium
2. How many products were reviewed with a focus on fair treatment of consumers and suitability in the reporting period?
*All products sold within the reporting period are to be listed in the first column “Product family” below.
Product family
Currently
available? (as of
Fiscal Year End)
Product category
Material changes
in the offer or in
the product?
If yes, indicate the
initial date of change Type of change
Did the change
result in a change in
the target market?
If it is a new product, indicate
the class of insurance
Comments or any additional
information
Yes Personal property Yes Product features Yes
No Private passenger No Pricing No
Automobile Product features & pricing Non applicable
Legal expense Discontinued product
Mortgage Non applicable
Marine
Credit
Liability
Accident and sickness
4. Products
1. How many products do you have?
3. General comments:
1.
Direct Premiums Written Claim incurred
BrokerDirect and
Exclusive AgentOther Total Broker
Direct and
Exclusive AgentOther Total Broker
Direct and
Exclusive AgentOther Total
1 Personal Property
2 Private Passenger Automobile
3 Legal Expense
4 Mortgage
5 Marine
6 Accident & Sickness
7 Credit protection
8 Liability
0 0 0 0 0 0 0 0 0 0 0 0
2. Do you sell your products through third parties or affinity arrangements? Yes
If yes, indicate the number of entities or arrangements that are used to sell your products:
3. Do you sell products through the Internet? Yes
If yes, please provide the following information for direct sales, excluding third party aggregators:
a) Number of policies sold
b) Direct premiums
4. General comments:
5. Premiums, Commissions and Claims
Commissions, including all types of variable
remunerationLines of Business
TOTAL
Premium, commissions and claims by distribution channel consolidated ($000)
Licensed? % of total
business
Distribution type Exclusivity
clause?
Binding
Authority?
Loans to firm
($000)
% participating
in firm’s equity
Minimum
volume
clause
First refusal
right over
firm
Other types of
advantage? (resource
loan, marketing, etc.) If
yes, list in # 2 below
Date of most
recent
compliance
review
Comments or any
additional information
01 Yes 0-5% Direct of exclusive Agent Yes Yes Yes Yes Yes
02 No 11-15% Independent Agent No No No No No
03 16-20% MGA
04 21-40% National Account
05 41-60% Other
06 61-75%
07 76-85%
08 85-100%
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
6. Distributors
2. Other type of advantage:
3. General comments:
Top 25 firms
1. THIS QUESTION IS RELATED TO DIRECT SALES ONLY (EXCLUDES THIRD-PARTY ARRANGEMENTS):
a) List by product below, the range of commissions paid (% of first annual premium) within the first year of the policy being in force:
(%)
(%)
Legal Expense (%)
Mortgage (%)
Marine (%)
Accident & Sickness (%)
Credit protection (%)
Liability (%)
b) List by product below, the range of commissions paid (% of renewal premium) within the second year of the policy being in force:
(%)
(%)
Legal Expense (%)
Mortgage (%)
Marine (%)
Accident & Sickness (%)
Credit protection (%)
Liability (%)
(%)
2.
Sales force Sales management
a) Cash prizes or other gifts
b) Money loan
c) Profit sharing
d) Bonus
3. For sales force only, indicate whether performance measures and incentives or commissions consider the following:
Performance MeasuresIncentives or
Commissions
a) Lapses
b) Number of complaints
c) Premium volume
d) Claims volume
e) Consumer satisfaction
f) Number of post-sale consumer
touches by sales force
g)
4. Other comments on variable remuneration:
7. Sales and Incentives Management
Excluding sales force whose remuneration is fully variable, identify the variable proportion of the remuneration in the
rows below:
For all sales force and sales management, list of compensation methods other than fixed commission and base salary
(Please, check all that apply to you):
Provide details of any other sales force performance measures and incentives or commissions you have that are based on the
fair treatment of consumers:
Personal property
Private Passenger Automobile
Personal property
Private Passenger Automobile
Group
e) Other, please specify in the
space below:
Type of variable remuneration
1. Complete the tablePersonal
Property
Private pasenger
AutomobileLegal Expense Mortgage Marine
Accident and
Sickness
Credit
protectionLiability
2.
Exclusions and limitations in the policy
Delay in submitting claim
Not covered, except for exclusions and limitations in the policy
Failure to disclose or misrepresentation of a material fact
Other, please specify in the space below
3. Other main reasons for claims denial:
4. Lawsuits:
a) Number of lawsuits outstanding at beginning of the period
b) Number of new lawsuits
c) Number of closed lawsuit, by pre-court settlements
d) Number of closed lawsuits, by Court judgement
e) Number of class action lawsuits
5. General Comments:
8. Claims
Please indicate the 3 main reasons for denial of claims in the reporting period and
the total number of denials for the three reasons selected:
Number of claims opened at the beginning of the period
Number of new claims opened during the period
Number of claims closed with payment during the period
Number of claims denied in the period
Number of claims open at the end of the period
Average days to final payment
Number of claims closed within 0-90 days from date of claim reported
Number of claims closed within 91-180 days from date of claim reported
Number of claims closed within 181-365 days from date of claim reported
Number of claims closed over 365 days from date of claim reported
a) Name of the senior officer:
b) Title:
c) Address:
d) Telephone number:
e) Email:
a) Name of the senior officer:
b) Title:
c) Address:
d) Telephone number:
e) Email:
a) Name of the senior officer:
b) Title:
c) Address:
d) Telephone number:
e) Email:
a) Complaint handling policies and procedures guideline
b) Complaint handling unit or department
c) Reporting mechanism on a periodic basis that is sent to management and the board regarding aggregate complaints
d) Ongoing training program regarding complaint handling for staff whose activities include complaint handling
4. Do you have any complaint information to be filed for the reporting period? (If yes, please complete the next tab) Yes
Yes
9. Complaint Reporting
3. Please indicate in the space below the stage of your complaint process at which you declare the complaint to the regulator:
2. Please indicate which of the following are present within your organization:
5. Does your report (table in next tab) contain new complaints for the reporting period?
1. Identify the senior officer(s) responsible for complaint handling at Fiscal Year end:
Firm's complaint
reference number
Complainant's postal code
(first three characters are
required)
Complaint file
opening date
Complaint file
closing date Complaint file closed
Product
category
If other,
specify
Type of
productDistribution channel
1 Declared for the first time-Closed during current declaration period Property Home Employer's representative
2 Declared for the first time-Not closed at the end of current decraration period Civil Liability Personal Independent agent, broker or MGA
3 Declared for the first time in a previous preriod-Closed during current period Travel Commercial Other (fill comments section)
4 Declared for the first time in a previous period-Not closed Auto Other
5 Declared for the first time in a previous period-Voided during this declaration period Other Non applicable
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
Information about the complaint Identification of the product related to complaint
9. Complaint Reporting
Complaint category Cause for complaintResult of complaint
examination
Did the complaint result in a
lawsuit (if known)
Was the complaint
transferred to a regulatory
authority (if known)
Comments or any additional information
1 Underwritting Premium Settled Yes Yes
2 Underwritting Policiy provisions Not settled No No
3 Underwritting Refusal Complaint withdrawn
4 Underwritting Customer service
5 Underwritting Challenge in risk category
6 Underwritting Alleged discrimination
7 Underwritting Credit scoring
8 Underwritting File confidentiality of insured
9 Underwritting Information collection and needs analysis
10 Underwritting Reporting to client
11 Underwritting Performance of mandate
12 Underwritting Other (fill comments section)
13 Administration Administrative procedures
14 Administration Customer service
15 Administration Statements
16 Administration Fees / commissions
17 Administration Preauthorized debit / payment plan
18 Administration Transfers
19 Administration Credit rating
20 Administration Non-authorized transaction
21 Administration Personal information protection
22 Administration Collection
23 Administration Other (fill comments section)
24 Marketing and sales Advertising
25 Marketing and sales Illustration of cost or return
26 Marketing and sales Alleged misleading statement or misrepresentation
27 Marketing and sales Replacement disclosure form
28 Marketing and sales Delivery of policy
29 Marketing and sales Tied selling
30 Marketing and sales Discontinuation / termination of service
31 Marketing and sales Other (fill comments section)
32 Product Policy value
33 Product Availability / accessibility
34 Product Renewal
35 Product Rate of return (ror)
36 Product Policy provisions
37 Product Prospectus
38 Product Adequacy of product
39 Product Other (fill comments section)
40 Claims / settlement Claim procedure
41 Claims / settlement Delay in settlement
42 Claims / settlement Refusal of claim
43 Claims / settlement Customer service
44 Claims / settlement Performance of mandate
45 Claims / settlement Suspension of benefit
46 Claims / settlement Reporting to client
47 Claims / settlement Other (fill comments section)
Cause for complaint and outcome of the complaint
9. Complaint Reporting (suite)
1.Do you have policies and procedures in place regarding breaches in confidentiality and the protection of
personal information?Yes
If yes, please indicate which of the following are addressed by your policies and procedures:
a) Timely notification to consumers of any breaches that could impact their interests or rights
b) Timely notification to the appropriate authorities of any breaches that could impact the consumer’s interests or rights
c) Timely notification to the responsible and appropriate individuals within your organization
Comments:
2. Have you had any breaches in the protection of personal information in the past year? Yes
If yes, indicate the number of breaches:
3. Were the breaches reported to the proper authorities where required by law (e.g., Privacy Commissioner,
regulatory authority)?Yes
If no, please provide details as to why the incident(s) was not reported to the appropriate authority:
10. Protection of Personal Information
11. Attestation
I (name) , ________________ OF THE ( city/town) __________________________ IN THE PROVINCE
BEING (title)____________________ RESPECTIVELY OF (name of insurer)
HEREINAFTER CALLED ("THE INSURER") DO MAKE OATH AND SAY AS FOLLOWS:
I HAVE MADE SUCH INQUIRIES, AS I BELIEVE REASONABLY REQUIRED OR APPROPRIATE TO ATTEST THAT, TO THE
BEST OF MY KNOWLEDGE AND BELIEF, THE FOREGOING ANNUAL STATEMENT ON MARKET CONDUCT,
TOGETHER WITH THE RELATED EXPLANATIONS FILED OR TO BE FILED AS PART THEREOF, IS TRUE AND
ACCURATE FOR THE INSURER IN RESPECT OF ITS BUSINESS OF INSURANCE, AS OF THE ………….. DAY OF
......................................... 20 ......., AND FOR THE YEAR ENDED ON THAT DAY; AND
ASPECTS OF THE INFORMATION BEING FILED ARE CONSIDERED COMMERCIALLY SENSITIVE IN NATURE AND
HAVE BEEN PROVIDED AS CONFIDENTIAL AND PRIVILEGED INFORMATION. IT IS EXPECTED THAT THE CANADIAN
COUNCIL OF INSURANCE REGULATORS (“CCIR”) AND ITS MEMBERS WILL TREAT AND PROTECT THIS
INFORMATION AS CONFIDENTIAL AND PRIVILEGED INFORMATION AND WILL NOT BE DISCLOSED UNLESS, to the
a. the information is publicly available;
b. the information is disclosed in a manner that does not directly or indirectly identify the Regulated Entity or
any individual;
c. the information disclosed is not harmful to the Regulated Entity or individual’s business or financial interests;
d. the entity or individual to which the information relates has consented to the disclosure;
e. the disclosure is necessary for the purpose of carrying out an investigation, enforcement proceeding or a
regulatory purpose of the Applicant Signatory; or
f. the disclosure is otherwise authorized under Applicable Law.
ANY SITUATION IN WHICH THIS INFORMATION WILL BE DISCLOSED, THE CCIR AND ITS MEMBERS ARE EXPECTED
TO PROVIDE PRIOR WRITTEN NOTICE TO THE INSURER.
____________________________________________
Signature
SEVERALLY SWORN TO BEFORE ME _______________________________________
AT __________________________ IN THE PROVINCE OF ______________________
THIS ______________________ DAY OF ______________________ 20_____